Thrombotic diseases are a leading cause of global mortality and disability, posing significant challenges in early diagnosis and precise treatment. With advancements in thrombosis mechanisms, biomarkers have evolved from single indicators to networks covering multiple pathophysiological processes. This article systematically integrates research progress and clinical value of various biomarkers around the core pathophysiological mechanisms of thrombosis, focusing on four dimensions: endothelial i...更多
Thrombotic diseases are a leading cause of global mortality and disability, posing significant challenges in early diagnosis and precise treatment. With advancements in thrombosis mechanisms, biomarkers have evolved from single indicators to networks covering multiple pathophysiological processes. This article systematically integrates research progress and clinical value of various biomarkers around the core pathophysiological mechanisms of thrombosis, focusing on four dimensions: endothelial injury and dysfunction, hypercoagulability and coagulation activation, inflammatory immunity and platelet activation, and fibrinolytic dysfunction. Among traditional biomarkers, D-dimer exhibits high negative predictive value but low specificity, while age correction and combined fibrinogen measurements can partially enhance efficacy. Coagulation factor VIII and THBD gene polymorphisms provide genetic information for venous thromboembolism risk assessment. Novel thrombosis quartet markers directly reflect thrombin generation, fibrinolysis activation, and endothelial injury, demonstrating significantly superior diagnostic performance to traditional indicators. These markers exhibit unique value in tumor-associated VTE, postoperative VTE, and risk assessment for special populations. Additionally, emerging molecules such as neutrophil extracellular traps , P-selectin, microRNAs, and platelet-inflammatory-related biomarkers offer new perspectives for thrombosis mechanism research and liquid biopsy. Risk assessment models for special populations significantly improve predictive accuracy when combined with molecular biomarkers. This article further establishes dedicated sections to systematically analyze standardization challenges faced by major emerging biomarkers across pre-analytical, analytical, and post-analytical stages, and explores the evidence-based steps required from research discovery to clinical guideline integration, providing a practical framework for translational research. Current studies still face limitations such as insufficient sample size, lack of external validation, unclear mechanisms, and scarce intervention evidence. Future efforts should focus on large-scale multicenter prospective validation, development of novel biomarkers, multi-omics joint modeling, and biomarker-guided individualized intervention clinical trials to comprehensively enhance the diagnosis and treatment of thrombotic diseases.收起
